T. Debillon et al., Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants, ARCH DIS CH, 85(1), 2001, pp. F36-F40
Objective-To develop and validate a scale suitable for use in clinical prac
tice as a tool for assessing prolonged pain in premature infants.
Methods-Pain indicators identified by observation of preterm infants and se
lected by a panel of experts were used to develop the EDIN scale (Echelle D
ouleur Inconfort Nouveau-Ne, neonatal pain and discomfort scale). A cohort
of preterm infants was studied prospectively to determine construct validit
y, inter-rater reliability, and internal consistency of the scale.
Results-The EDIN scale uses five behavioural indicators of prolonged pain:
facial activity, body movements, quality of sleep, quality of contact with
nurses, and consolability. The validation study included 76 preterm infants
with a mean gestational age of 31.5 weeks. Inter-rater reliability was acc
eptable, with a K coefficient range of 0.59-0.74. Internal consistency was
high: Cronbach's alpha coefficients calculated after deleting each item ran
ged from 0.86 to 0.94. To establish construct validity, EDIN scores in two
extreme situations (pain and no pain) were compared, and a significant diff
erence was observed.
Conclusions-The validation data suggest that the EDIN is appropriate for as
sessing prolonged pain in preterm infants. Further studies are warranted to
obtain further evidence of construct validity by comparing scores in less
extreme situations.